Hospital executives are balancing their hopes that expanded coverage will provide a windfall for facilities now burdened by uncompensated care with their fears that government intervention, such as the possible creation of a public insurance option, could cut into their revenues, the Atlanta Journal-Constitution
reports. In addition to concerns over the public option, hospitals worry comparative effectiveness research could force them to use cheaper treatments. Also, a proposal to cut rates for hospital readmissions would put the blame for the repeat episode entirely on the hospital, one executive said (Schnieder, 9/8).
In the hope column, hospitals are looking at reform efforts to stop the unraveling of emergency room "safety nets." "We have become the primary diagnostician for uninsured people with lung cancer, brain cancer, breast cancer, because people put off seeing a doctor when they have minor symptoms," one emergency room doctors told the Palm Beach Post
. The situation highlights both the effectiveness of emergency care, and a key reform problem: emergency rooms are required to take all comers, but many can't pay. The cost of their care is made up by government funding, and by shifting the hospitals' costs to patients with good insurance to the tune of $3,100 per hospital visit. A Florida hospital official says covering the uninsured would help relieve hospitals and lower premiums for other patients (Singer, 9/8).